New Family Membership Application

If you choose manual payment method at the bottom of this form, make your check payable to “CCWR” and mail it to:

CCWR
c/o Ruth McDunn
1482 Hugo Lane
San Jose, CA 95118

Login Information

Username*An email address can be used as your username. Note that usernames cannot be changed and must be unique.

Password*Type your password. Minimum length of 6 characters

Repeat Password*Type your password again.

Primary Contact

Salutation

First Name*

Last Name*

Suffix

E-mail*

Confirm Email*

Street Address*

City*

State*

Zipcode*

County*

Region*What CDFW region do you work in? A description of the regions is located at CDFW Regions.

Phone*

Phone (Alternate)

Affiliation*What rehabilitation facility are you affiliated with?

Website

What year did you start in wildlife rehabilitation?

Second Contact Info

Contact 2 Salutation

Contact 2 First Name

Contact 2 Last Name

Contact 2 Suffix

Email

Permits and Areas of Expertise

State Permits*

No State Permits

Bird Banding

Display/Exhibition

Falconry

Nuisance Wildlife Removal

Rabies Vector Species

Restricted Species

Salvage/Special Possession

Threatened/Endangered Species

Venomous Reptile

Wildlife Rehabilitation

Wildlife Education

Do you hold any state permits?

Federal Permits*

No Federal Permits

Bird Banding

Falconry

Display/Exhibition

Restricted Species

Salvage/Special Possession

Threatened/Endangered Species

USDA

Wildlife Education

Wildlife Rehabilitation

Do you hold any Federal permits?

Areas of Expertise*

Aerial Insectivores

Aquatic Birds

Bats

Bobcat

Caging (Design and Construction)

Columbiformes (Doves and Pigeons)

Corvids (Jays/Crows/Ravens)

Coyote

Deer/Fawns

Eagles

Education

Fostering

Fox

Fundraising

Gamebirds (Turkeys and Quail)

Hawks

Holistic/Homeopathy

Humane Wildlife Exclusion

Hummingbirds

Killdeer

Networking

Oiled Wildlife

Opossum

Owls

Passerines

Rabbit

Raccoon

Raptors (other than eagle/hawk/owl)

Reptiles

Reuniting

Seabirds

Shorebirds

Skunks

Snakes

Squirrels

Swallows/Swifts

Waterbirds

Waterfowl

Woodpecker

None

Select no more than 3 areas. You must have at least 3 years of experience before adding an area to this field. Please note that members may use this information to help the public locate a rehabilitator and the information will be available in our online member directory.

Other Areas of ExpertiseOther areas of expertise not already selected above. You must have at least 3 years of experience before adding an area to this field. Please note that members may use this information to help the public locate a rehabilitator and will be available in our online member directory.

Preferences

Do you want the Newsletter by email only?*

Yes - email only

No

Do you want to be listed in the online directory?*

Yes - List in the Directory

Do not list

Do you want to subscribe to the Gaggle Listserve?*

Yes - subscribe

No - do not subscribe

HOW IT WORKS
When you send an email to ccwrlist@ccwr.org every subscriber will get the email message. If you reply to a message, every subscriber of the list will receive the email (like "reply all"). There will be a link at the bottom of each message you if you want to reply directly to the subscriber and not the entire list. It is good practice to include your name, location and affiliation on all messages. Only active CCWR members are allowed to participate in this unmoderated list.

Family Member Subscriptions

Choose your level of membership. Family memberships allow two individuals to receive the special membership rate at the CCWR symposia and two votes during board elections.

Family Membership - 3 years - $100 / 3 Years

Family membership entitles two people from the household to the special membership rate at the symposium and two votes during board elections. Family membership for 3 years is $100, a $50 savings over a 1 year membership.

Family Membership - 2 years - $80 / 2 Years

Family membership entitles two people from the household to the special membership rate at the symposium and two votes during board elections. Family membership for 2 years is $80, a $20 savings over a 1 year membership.

Family Membership - 1 year - $50 / 1 Year

Family membership entitles two people from the household to the special membership rate at the symposium and two votes during board elections. Family membership for 1 year is $50.